End Stage Kidney Disease Clinical Trial
Official title:
Blood Volume Analysis and Related Outcomes in Hemodialysis
An understanding of fluid changes that occur during hemodialysis (HD) with ultrafiltration (UF) is essential for determining the efficacy of HD, as well as for reducing complications related to hypovolemia or, conversely, chronic volume overload.
Background: Accurate assessment of the BV and distribution of body fluids is essential for
prescribing HD and for reducing complications related to hypovolemia and volume overload.
Monitoring relative changes in BV using hematocrit (Hct), e.g. CLM-III, an indirect method,
cannot be used to determine the absolute levels of BV. Here we report the first study of
isotope BV measurement (IBVM) for assessing volume status in HD patients using indicator
dilutional method.
10 adult HD patients were enrolled in this prospective observational study. Multi-point IBVM
before and after HD was performed using BVA-100 (Daxor, New York, NY). BVA-100 calculates BV
with an accuracy of ±2.5%, by using <25μCi of iodinated I-131 albumin. It assumes normal BV
for a given individual on the basis of patients' deviation from ideal body weight. Fluid
loss from the extravascular component of the extracellular space (EV) was calculated by
subtracting absolute BV change from total weight loss. Intradialytic relative BV changes
were measured by CLM-III during the same HD session. Bland-Altman plot was used to compare
relative BV change pre- and post-HD by IBVM and CLM-III.
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Observational Model: Case-Only, Time Perspective: Prospective
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